血清肿瘤标志物及其组合模式对肺癌诊断及分型的价值研究

目的评价单一肿瘤标志物及其组合模式在肺癌诊断及分型中的临床价值。方法检测肺癌患者(88例)及肺良性疾病患者(45例)血清中癌胚抗原(CEA)、神经元特异性烯醇酶(NSE)及促胃液素释放肽前体(ProGRP),应用受试者工作特征(ROC)曲线和Youden指数评价肿瘤标志物及其组合模式对肺癌的诊断价值,筛选最优肿瘤标志物及其组合模式。结果肺癌组患者CEA、NSE、ProGRP3种血清肿瘤标志物水平与良性疾病组比较差异均有统计学意义(P<0.05)。单一指标CEA的ROC下面积最大。CEA ProGRP NSE3项组合模式的特异度、正确率和Youden指数明显升高,灵敏度轻度下降,其值分别是94.6%、81.5%、0.672和72.6%,是最佳诊断组合。结论血清肿瘤标志物及其组合模式能敏感、特异地进行肺癌的诊断,并对分型有提示价值。

Values of Serum Tumour Markers and Their Patterns in Lung Cancer Diagnosis and Its Type Differentiation

Objective To evaluate the clinical significance of serum tumour markers and their patterns for lung cancer diagnosis.Methods The three serum tumour markers including carcinoembryonic antigen (CEA),neuron-specific enolase (NSE) and progastrin-releasing peptide (proGRP) were detected in 88 lung cancer patients and 45 benign lung disease.The ROC curve and Youden index were used to select the highest sensitivity diagnostic pattern.Results These three markers level in the lung cancer group were obviously higher than those in the lung benign disease group (P<0.05).In single index the ROC area of serum CEA was the largest.The CEA ProGRP NS were the best diagnostic ability for lung cancer.The pattern was of obviously increased specificity,right diagnosis rate and Youden index,with a slightly decreased sensibility;their values were 94.6%,81.5%,0.672 and 72.6% respectively.Conclusion These tumour markers and their pattern are sensible and specific for diagnosis of lung cancer,and have some indicating values in type differentiation.